Distal radius plating system

ABSTRACT

Systems and methods are described for treating distal radius fractures using a plating system. In an aspect, a distal radius plating system includes a volar plate body for interfacing with a volar side of a distal portion of a radius bone. The volar plate body has a volar head portion extending from the volar plate body and terminating at a distal edge, the volar head portion including a first set of apertures to receive fixation fasteners therethrough to fix to the radius bone. The distal radius plating system also includes a radial longitudinal portion extending from a radial edge of the volar plate body to interface with the radial styloid of the radius bone while the volar plate body is positioned on the volar side of the distal portion of the radius bone.

BACKGROUND

Bone fractures of the wrist typically require stabilization of bonefragments of the distal radius to facilitate proper alignment of bonefragments during the healing process. Stabilization methods can includeexternal fixation techniques (e.g., casting, external fixators) andinvasive fixation techniques (pinning/wiring, plating).

SUMMARY

In an aspect, a distal radius plating system includes, but is notlimited to, a volar plate body and a radial longitudinal portionextending from the radial edge of the volar plate body. The volar platebody has an exterior surface and a bone-facing surface opposing theexterior surface, a radial edge and an ulnar edge opposing the radialedge, and a proximal edge and a distal edge opposing the proximal edge.The volar plate body is longitudinally disposed between the proximaledge and the distal edge and has a size and shape for interfacing with avolar side of a distal portion of a radius bone via the bone-facingsurface. The volar plate body defines a plurality of apertures from theexterior surface to the bone-facing surface to receive fixationfasteners therethrough to fix to the radius bone. The volar plate bodyhas a volar head portion extending from the volar plate body andterminating at the distal edge, where the volar head portion includes afirst set of apertures from the exterior surface to the bone-facingsurface to receive fixation fasteners therethrough to fix to the radiusbone and has a second set of apertures from the exterior surface to thebone-facing surface to receive stabilization wire therethrough tointerface with the radius bone. The radial longitudinal portion has alateral extension portion coupled with the volar plate body and a radialextension portion coupled with the lateral extension portion, where thelateral extension portion curves from the exterior surface toward thebone-facing surface. The radial extension portion extends in a directionfrom the proximal edge toward the distal edge. The radial extensionportion has a radial exterior surface and a radial bone-facing surfaceopposing the radial exterior surface. The radial extension portion hasat least a first aperture from the radial exterior surface to the radialbone-facing surface to receive fixation fasteners therethrough to fix tothe radius bone and has at least a second aperture to receivestabilization wire therethrough to interface with the radius bone,wherein at least a portion of the radial bone-facing surface issubstantially orthogonal to at least a portion of the bone-facingsurface of the volar plate body.

In an aspect, a method of treating a patient having a distal radiusfracture using a distal radius plating system includes, but is notlimited to, introducing a distal radius plating system to a distalportion of a radius bone of a patient through a volar incision on thepatient and securing at least a portion of the distal radius platingsystem to the distal portion of the radius bone. The distal radiusplating system of the method includes, but is not limited to, a volarplate body and a radial longitudinal portion extending from the radialedge of the volar plate body. The volar plate body has an exteriorsurface and a bone-facing surface opposing the exterior surface, aradial edge and an ulnar edge opposing the radial edge, and a proximaledge and a distal edge opposing the proximal edge. The volar plate bodyis longitudinally disposed between the proximal edge and the distal edgeand has a size and shape for interfacing with a volar side of the distalportion of the radius bone via the bone-facing surface. The volar platebody defines a plurality of apertures from the exterior surface to thebone-facing surface to receive fixation fasteners therethrough to fix tothe radius bone. The volar plate body has a volar head portion extendingfrom the volar plate body and terminating at the distal edge, where thevolar head portion includes a first set of apertures from the exteriorsurface to the bone-facing surface to receive fixation fastenerstherethrough to fix to the radius bone and has a second set of aperturesfrom the exterior surface to the bone-facing surface to receivestabilization wire therethrough to interface with the radius bone. Theradial longitudinal portion has a lateral extension portion coupled withthe volar plate body and a radial extension portion coupled with thelateral extension portion, where the lateral extension portion curvesfrom the exterior surface toward the bone-facing surface. The radialextension portion extends in a direction from the proximal edge towardthe distal edge. The radial extension portion has a radial exteriorsurface and a radial bone-facing surface opposing the radial exteriorsurface. The radial extension portion has at least a first aperture fromthe radial exterior surface to the radial bone-facing surface to receivefixation fasteners therethrough to fix to the radius bone and has atleast a second aperture to receive stabilization wire therethrough tointerface with the radius bone, wherein at least a portion of the radialbone-facing surface is substantially orthogonal to at least a portion ofthe bone-facing surface of the volar plate body.

DRAWINGS

The Detailed Description is described with reference to the accompanyingfigures. The use of the same reference numbers in different instances inthe description and the figures may indicate similar or identical items.

FIG. 1 is an isometric view of a distal radius plating system inaccordance with an example embodiment of the present disclosure, shownin a left-handed configuration.

FIG. 2 is an isometric view of the distal radius plating system of FIG.1 illustrating the bone-facing surfaces.

FIG. 3 is a top view of the distal radius plating system of FIG. 1.

FIG. 4 is a bottom view of the distal radius plating system of FIG. 1.

FIG. 5 is a side view of the distal radius plating system of FIG. 1shown in a left-handed configuration, viewed from the radial side.

FIG. 6 is a side view of the distal radius plating system of FIG. 1shown in a left-handed configuration, viewed from the ulnar side.

FIG. 7 is environmental view of the distal radius plating system of FIG.1 in position on a radius bone of a patient.

FIG. 8 is an exploded environmental view of the distal radius platingsystem of FIG. 7, showing fixation fasteners utilized to secure thedistal radius plating system to the radius bone or fragments thereof.

FIG. 9 is an isometric view of a distal radius plating system inaccordance with an example embodiment of the present disclosure, shownin a right-handed configuration.

DETAILED DESCRIPTION

Distal radius fractures, or fractures of the wrist, can result fromexternal forces applied to the wrist, such as through physical traumacaused by a fall or other impact to the arm, wrist, or hand. Such forcescan cause portions of the wrist to break into fragments, particularlyfor bones susceptible to fracture (e.g., those affected by osteoporosisor the like). For instance, distal radial fractures can includeintra-articular fractures resulting in fragments of the radial styloid,lunate fossa, etc. Such fragmentation can include comminuted fracturepatterns, requiring dedicated alignment, fixation, or stabilizationsystems to treat the injury by moving the fragments back into properposition (a “reduction” technique) and preventing the fragments frommoving out of position during the healing process. If untreated orimproperly aligned, the bone fragments may not be in proper positionduring the healing process, which can result in pain or discomfort,reduction in range of motion, and other symptoms. Alignment, fixation,or stabilization techniques include casting, external fixation, internalpinning/wiring, and internal plating. Casting techniques provide anexternal fixation technique via substantially rigid external casts in anattempt to stabilize internal wrist fractures, but often lack theprecision to treat complex fractures such as comminuted fractures orother fragmentation. External fixators provide tension to ligamentssurrounding the wrist fracture in an attempt to bring the fragments intoalignment, but as with casting, often lack the requisite precision toproperly align multiple distal radius fragments. Pinning and wiringtechniques provide invasive alignment and fixation methods by utilizingpins and/or wires to hold fragments relative to other fragments or otherportions of the wrist. These techniques can introduce inconsistencies insurgical applications between differing surgeons or between differingpatients, which can provide inconsistent treatment results. Further, thepinning and wiring may be insufficient to stably fix bone fragments whenthe area surrounding the fragments includes additional fragments (e.g.,comminuted bone) or is osteoporotic (e.g., lacking proper structuralbone support). Internal plating involves introducing and fixing a plateto a bone surface, such as the dorsal or volar side of the radius, andintroducing screws through the plating into the bone fragments to fixthem relative to the bone. Other plating utilizes fragment specificplating over other portions of the distal radius, however such fragmentspecific plating can increase the amount of hardware needed to securethe plating relative to a volar plating system, or can increase the riskfor flexor tendon irritation and/or rupture.

Referring generally to FIGS. 1 through 9, systems and methods fortreating distal radius fractures using a distal radius plating systemare described. The distal radius plating systems and methods provide acomprehensive treatment to distal radius fractures through applicationof a volar plate body with a volar head portion and a radiallongitudinal portion. The volar head portion supports and stabilizesvolar distal radial fractures while the radial longitudinal portionsupports the radial distal portion of the radius to stabilize and fixfragments radially while the volar plate body and the volar head portionsimultaneously provide the volar support. For example, the radiallongitudinal portion controls positioning of a radial styloid fragmentand the volar head portion or a buttress thereof can control volar ulnarcorner and lunate facet fixation. Further, the distal radius platingsystem can facilitate dorsal ulnar corner fragment stabilization throughapplication of anatomically placed volar to dorsal screws (e.g., via thevolar head portion) and suture rope with attached brad or button. Stillfurther, the distal radius plating system can facilitate radialcolumn/radial fragment stabilization through a combination of radial toulnar screws (e.g., via the radial longitudinal portion) and securingwire (e.g., Kirschner or K-wire).

The radial longitudinal portion extends from the volar plate bodylongitudinally along the radial side, which keeps plating away from theregion of the wrist occupied by the flexor tendons and the flexorpollicis longus, thereby reducing the likelihood of flexor tendonirritation, flexor tendon rupture, or flexor pollicis longus ruptureresulting from inefficient distal radial plating systems. The connectionof the radial longitudinal portion to the volar plate body providesstructure stability to the radial longitudinal portion, thus limitingthe amount or number of screws utilized for radial styloid fragmentfixation or radial fracture fixation, while avoiding hardware utilizedfor oblique-angled screws directed at the radial styloid from avolar-based plate. The distal radius plating systems described hereincan be introduced to the distal radius of a patient through a volarincision on the patient, thereby enabling radial longitudinal fixationof a radial styloid fragment or a radial styloid fracture through anincision type that is a standard for many surgeons for volar fixation.

Referring to FIGS. 1 through 9, distal radius plating systems 100 aredescribed. A distal radius plating system (“system 100”) includes avolar plate body 102 for positioning against a radius bone of a patient,specifically applied to the volar distal radius. The system 100 shown inFIGS. 1 through 8 is provided as a left-handed configuration. The system100 shown in FIG. 9 is provided as a right-handed configuration. Thesystem 100 includes a volar head portion 104 and a radial longitudinalportion 106 extending from the volar plate body 102. The volar platebody 102 provides a platform to assist with stabilization of the volarhead portion 104 and of the radial longitudinal portion 106 as the volarhead portion 104 is applied to the distal radius to stabilize and fixfractures and fragments from the volar side of the radius and as theradial longitudinal portion 106 is applied to the radial distal portionof the radius to stabilize and fix fractures and fragments radially.FIGS. 7 and 8 show an example installation of the system 100 on a radiusbone 50 of a patient 52, e.g., as applied through a volar incision onthe patient 52.

The volar plate body 102 generally includes an exterior surface 108 andan opposing bone-facing surface 110 (e.g., shown in FIG. 2), a radialedge 112 and an opposing ulnar edge 114 (e.g., shown in FIG. 2), and aproximal edge 116 and opposing distal edge 118 (e.g., shown in FIG. 2).The volar plate body 102 is generally longitudinally disposed betweenthe proximal edge 116 and the distal edge 118 and includes a size andshape for interfacing with a volar side of a distal portion of a radiusbone via the bone-facing surface 110. The volar plate body 102 defines aplurality of apertures to receive fixation fasteners (e.g., pegs,screws, pins, wires, etc.) to be introduced to the underlying bone andheld against the exterior surface 108. For example, apertures 120 and122 are shown, where apertures 120 receive a fixation fastener in agenerally fixed position through a circular-shaped opening and whereaperture 122 provides an elongated opening to receive a fixationfastener. The elongated opening of aperture 122 can permit generallylongitudinal movement of the volar plate body 102 relative to thefixation fastener within the aperture 122 prior to securing the fastener(e.g., a fastener head thereof) against the exterior surface 108 of thevolar plate body 102. While three apertures are shown positioned throughthe volar plate body 102, the present disclosure is not limited to threeapertures, and can include fewer than three apertures through the volarplate body 102 (e.g., one aperture or two apertures) or more than threeapertures (e.g., four apertures, five apertures, six apertures, etc.) toprovide the desired level of fixation of the volar plate body 102relative to the radius. Further, while the apertures 120 are shown asgenerally circular apertures, the apertures 120 are not limited tocircular cross sections and can have other cross-sectional shapesdepending on the type of fixation fastener utilized, including, but notlimited to, slotted, triangular, rectangular, pentagonal, hexagonal, andso forth.

In implementations, the volar plate body 102 defines a longitudinalchannel 124 (e.g., shown in FIG. 2) on the bone-facing surface 110 tointerface with at least a portion of the radius bone. For example, thelongitudinal channel 124 can provide a contoured surface into which avolar portion of the radius bone can be inserted, such as to providestability, fit, and assisted alignment of the system 100 for a surgeonduring installation. The longitudinal channel 124 can traverse thebone-facing surface 110 of the volar plate body 102 from the proximaledge 116 toward the distal edge 118. For example, the longitudinalchannel 124 is shown as originating at the proximal edge 116 andterminating at a portion of the volar head portion 104.

The volar head portion 104 extends from the volar plate body 102 andterminates at the distal edge 118. In implementations, the volar headportion 104 is laterally offset toward the ulnar edge 114 (e.g., towardsthe ulna when in position on the radius) relative to the generallongitudinal direction of the volar plate body 102 (e.g., as shown inFIG. 3). The offset of the volar head portion 104 with respect to thevolar plate body 102 can provide spacing between the volar head portion104 and the radial longitudinal portion 106 to accommodate the region ofthe wrist occupied by the flexor tendons and the flexor pollicis longus.For instance, the relative positioning of the volar head portion 104 andthe radial longitudinal portion 106 can provide a lack of plating at theregion of the wrist occupied by the flexor tendons and the flexorpollicis longus, thereby reducing the likelihood of flexor tendonirritation, flexor tendon rupture, or flexor pollicis longus rupture,while still providing longitudinal fixation support at the radial sideof the distal radius.

The volar head portion 104 defines a plurality of apertures to receivefixation fasteners (e.g., pegs, screws, pins, wires, etc.) to beintroduced to the underlying bone and held against the exterior surface108. For example, two sets of apertures are shown, apertures 126 andapertures 128. Apertures 126 are shown having a generally circularcross-section that has a cross-sectional area that is less than thegenerally circular cross-section of apertures 128. For instance, theapertures 126 extend from the exterior surface 108 to the bone-facingsurface 110 to receive stabilization wire (e.g., K-wire) or otherfixation fastener to interface with the distal radius bone and fragmentsthereof. The smaller aperture size can facilitate precision fasteners tofix and stabilize the relatively small distal radius fragments orcomminuted fragments that can occur with wrist fractures. The apertures128 extend from the exterior surface 108 to the bone-facing surface 110to receive screws, pegs, or other fixation fastener to interface withthe distal radius bone and fragments thereof. The volar head portion 104is shown with four apertures 126 laterally arranged with respect to eachother at the distal end of the volar head portion 104. Alternatively oradditionally, the volar head portion 104 can include or support one ormore buttresses to extend support surfaces to areas of the distalradius, where such buttresses can include apertures (e.g., apertures126) to receive fixation fasteners to fix and stabilize fragmentsadjacent to the buttresses. For example, the volar head portion 104 orone or more buttresses thereof can extend to the volar ulnar corner ofthe distal radius to support, fix, and stabilize fractures and fragmentsin that region via introduction of fixation fasteners to the aperture(s)(e.g., aperture 126) to facilitate volar ulnar fixation and lunate facetfixation. In implementations, dorsal ulnar corner fragment stabilizationis facilitated through application of anatomically placed volar todorsal screws through the volar head portion 104 with application ofsuture rope with attached brad or button. While four apertures 126 areshown positioned through the volar head portion 104, the presentdisclosure is not limited to four apertures 126, and can include fewerthan four apertures 126 through the volar head portion 104 (e.g., oneaperture, two apertures, or three apertures) or more than four apertures126 (e.g., five apertures, six apertures, seven apertures, etc.) toprovide the desired level of fixation of the volar head portion 104relative to the radius and fragments thereof.

The apertures 128 are shown having two apertures 128 laterally disposedwith respect to each other and one aperture 128 offset longitudinallytoward the proximal edge 116 of the volar plate body 102 in a generallytriangular arrangement of apertures 128. While three apertures 128 areshown in the generally triangular arrangement, other patterns ofapertures 128 can be utilized to support the volar head portion 104relative to the distal radius. For instance, additional apertures 128can be included to provide a surgeon with options for desired regions offixation to the underlying bone depending upon the location of fracturesor fragments of the wrist. Further, while the apertures 126 and 128 areshown as generally circular apertures, the apertures 126 and 128 are notlimited to circular cross sections and can have other cross-sectionalshapes depending on the type of fixation fastener utilized, including,but not limited to, slotted, triangular, rectangular, pentagonal,hexagonal, and so forth.

In implementations, at least a portion of the volar head portion 104 isvertically displaced from the volar plate body 102 to contour to thesurface of the radius as the radius extends from the radial column tothe distal end. For example, as shown in FIG. 7, the volar head portion104 is angled outwardly (shown as angle α) from the volar plate body 102in a direction from the bone-facing surface 110 to the exterior surface108. In implementations, the angle α is from approximately 15 degrees toapproximately 30 degrees displaced from the volar plate body 102.

The system 100 includes the radial longitudinal portion 106 extendingfrom the radial edge 112 of the volar plate body 102 to providelongitudinal fixation along the radial side of the distal radius whileavoiding plating at the region of the wrist occupied by the flexortendons and the flexor pollicis longus. As shown, the radiallongitudinal portion 106 includes a lateral extension portion 130 and aradial extension portion 132. The lateral extension portion 130 iscoupled with the volar plate body 102 and the radial extension portion132 is coupled with the lateral extension portion 130 to form a cohesiveplating system for securing to each of the volar distal radius and theradial side distal radius simultaneously. The radial longitudinalportion 106 curves out from the plane of the volar plate body to providea bone-facing surface against the radial side of the distal radius. Forinstance, the lateral extension portion 130 curves from the volar platebody 102 in a direction from the exterior surface 108 toward thebone-facing surface 110 to position the radial extension portion 132along the radial side of the distal radius. As shown in FIG. 3, thelateral extension portion 130 laterally extends from the radial edge 112of the volar plate body 102 at an intermediate portion of the radialedge 112 between the proximal edge 116 and the distal edge 118. Forexample, the intermediate portion is approximately at a middle portionof the radial edge 112 between the proximal edge 116 and the distal edge118 (shown between L₁ and L₂ in FIG. 3).

The radial extension portion 132 extends longitudinally from the lateralextension portion 130 in a direction from the proximal edge 116 towardthe distal edge 118. The radial extension portion 132 includes a radialexterior surface 134 and an opposing radial bone-facing surface 136(e.g., shown in FIG. 2). As shown in FIG. 4, the radial exterior surface134 and the radial bone-facing surface 136 are substantially orthogonal(e.g., from 80 degrees to 100 degrees offset) to at least a portion ofthe bone-facing surface 110 of the volar plate body 104 to permitinterfacing with each of the volar distal radius and the radial sidedistal radius simultaneously. For example, the volar plate body 102 candefine a longitudinal plane extending between the external surface 108and the bone-facing surface 110, where the radial bone-facing surface136 is positioned substantially orthogonally to the longitudinal plane.Since the bone surface of the radial side of the distal radius can havemore contours or curves than the radial column to which the volar platebody 102 can be secured, the radial extension portion 132 may be curved(e.g., on the radial bone-facing surface 136) to conform to suchcontours or curves. For instance, the radial extension portion 132 caninclude malleable materials (e.g., surgical grade metals) having athickness suitable for bending into shape prior to or during thesurgical installation procedure to conform the radial extension portion132 to the bone surface of the radial side of the distal radius. Theradial longitudinal portion 106 has a size and shape to interface theradial extension portion 132 with a radial styloid portion or a radialstyloid fragment of the radius bone while the volar plate body 102interfaces with the volar side of the distal portion of the radius bone.In implementations, an example of which is shown in FIGS. 4-6, thedistal edge of the radial extension portion 132 extends beyond thedistal edge of the volar head portion 104 (e.g., shown as di in FIG. 4)when positioned at the distal radius, such as to provide additionalsupport to the radial styloid which projects beyond the other bonesurfaces of at the distal radius. In implementations, the volar headportion 104 has a size and shape to bring at least a portion of thedistal edge 118 in contact with the radius bone adjacent to the lunatefacet while the radial extension portion 132 interfaces with a radialstyloid portion or a radial styloid fragment of the radius bone. Inimplementations, the volar head portion 104 has a size and shape tobring at least a portion of the distal edge 118 in contact with a volarulnar portion or a volar ulnar fragment of the radius bone while theradial extension portion 132 interfaces with a radial styloid portion ora radial styloid fragment of the radius bone. In implementations, thevolar head portion 104 has a size and shape to bring at least a portionof the distal edge 118 adjacent to a watershed line of the radius boneat a volar ulnar corner but not at the watershed line of the radius boneat a radial side of the radius bone while the radial extension portion132 interfaces with a radial styloid portion or a radial styloidfragment of the radius bone. Such a configuration can prevent platingbeing present at the region of the wrist occupied by the flexor tendonsand the flexor pollicis longus.

The radial extension portion 132 defines a plurality of apertures toreceive fixation fasteners (e.g., pegs, screws, pins, wires, etc.) to beintroduced to the underlying bone and held against the radial exteriorsurface 134. For example, two sets of apertures are shown, apertures 138and apertures 140. Apertures 138 are shown having a generally circularcross-section that has a cross-sectional area that is less than thegenerally circular cross-section of apertures 140. For instance, theapertures 138 extend from the radial exterior surface 134 to the radialbone-facing surface 136 to receive stabilization wire (e.g., K-wire) orother fixation fastener to interface with the distal radius bone andfragments thereof. The smaller aperture size can facilitate precisionfasteners to fix and stabilize from the radial side the relatively smalldistal radius fragments or comminuted fragments that can occur withwrist fractures. The apertures 140 extend from the radial exteriorsurface 134 to the radial bone-facing surface 136 to receive screws,pegs, or other fixation fastener to interface with the distal radiusbone and fragments thereof from the radial side of the bone. The radialextension portion 132 is shown with four apertures (e.g., two apertures138 and two apertures 140) longitudinally arranged with respect to eachother at the distal end of the radial extension portion 132. While fourapertures are shown positioned through the radial extension portion 132,the present disclosure is not limited to four apertures, and can includefewer than four apertures through the radial extension portion 132(e.g., one aperture, two apertures, or three apertures) or more thanfour apertures (e.g., five apertures, six apertures, seven apertures,etc.) to provide the desired level of fixation of the radial extensionportion 132 relative to the radial side of the distal radius andfragments thereof. Further, while the radial extension portion 132 isshown with a longitudinal arrangement of apertures, other patterns ofapertures 138 and 140 can be utilized to support the radial extensionportion 132 relative to the radial side of the distal radius. Forinstance, additional apertures 138 or 140 can be included to provide asurgeon with options for desired regions of fixation to the underlyingbone depending upon the location of fractures or fragments of the wrist.Further, while the apertures 138 and 140 are shown as generally circularapertures, the apertures 138 and 140 are not limited to circular crosssections and can have other cross-sectional shapes depending on the typeof fixation fastener utilized, including, but not limited to, slotted,triangular, rectangular, pentagonal, hexagonal, and so forth.

The system 100 can be introduced to the radius bone of the patientthrough a volar incision on the patient, where the volar plate body 102and volar head portion 104 can be secured to volar side of theunderlying radius bone (e.g., via one or more fixation fasteners 142,such as a peg or screw, as shown in FIG. 8) and where the radialextension portion 132 can be secured to the radial side of theunderlying radius bone (e.g., via one or more fixation fasteners 142,such as a peg or screw, as shown in FIG. 8) through the same volarincision. As such, the system 100 can facilitate radial longitudinalfixation of a radial styloid fragment or a radial styloid fracturethrough an incision type (i.e., volar incision) that is a standard formany surgeons for volar fixation.

The system 100 is generally constructed from surgical grade materials(e.g., biocompatible materials) where such materials have a strength andrigidity to support the volar plate body 102, the volar head portion104, and the radial longitudinal portion 106 relative to the underlyingportions of the distal radius, including fractures or fragments thereof.As an example, the system 100 can be constructed from surgical gradetitanium or alloys thereof, stainless steel, cobalt chromium alloys, orcombinations thereof. The system 100 can be formed from a single piececonstruction and bent or otherwise shaped into the conformationsdescribed herein. Alternatively, portions of the system 100 can beseparately formed and fused or otherwise bonded to other portions of thesystem 100.

Although the subject matter has been described in language specific tostructural features and/or process operations, it is to be understoodthat the subject matter defined in the appended claims is notnecessarily limited to the specific features or acts described above.Rather, the specific features and acts described above are disclosed asexample forms of implementing the claims.

What is claimed is:
 1. A distal radius plating system, comprising: avolar plate body, the volar plate body having an exterior surface and abone-facing surface opposing the exterior surface, a radial edge and anulnar edge opposing the radial edge, and a proximal edge and a distaledge opposing the proximal edge, the volar plate body longitudinallydisposed between the proximal edge and the distal edge and having a sizeand shape for interfacing with a volar side of a distal portion of aradius bone via the bone-facing surface, the volar plate body defining aplurality of apertures from the exterior surface to the bone-facingsurface to receive fixation fasteners therethrough to fix to the radiusbone, the volar plate body having a volar head portion extending fromthe volar plate body and terminating at the distal edge, the volar headportion including a first set of apertures from the exterior surface tothe bone-facing surface to receive fixation fasteners therethrough tofix to the radius bone and having a second set of apertures from theexterior surface to the bone-facing surface to receive stabilizationwire therethrough to interface with the radius bone; and a radiallongitudinal portion extending from the radial edge of the volar platebody, the radial longitudinal portion having a lateral extension portioncoupled with the volar plate body and a radial extension portion coupledwith the lateral extension portion, the lateral extension portioncurving from the exterior surface toward the bone-facing surface, theradial extension portion extending in a direction from the proximal edgetoward the distal edge, the radial extension portion having a radialexterior surface and a radial bone-facing surface opposing the radialexterior surface, the radial extension portion having at least a firstaperture from the radial exterior surface to the radial bone-facingsurface to receive fixation fasteners therethrough to fix to the radiusbone and having at least a second aperture to receive stabilization wiretherethrough to interface with the radius bone, the radial longitudinalportion having a size and shape to interface the radial extensionportion with a radial styloid portion or a radial styloid fragment ofthe radius bone while the volar plate body interfaces with the volarside of the distal portion of the radius bone, wherein at least aportion of the radial bone-facing surface is substantially orthogonal toat least a portion of the bone-facing surface of the volar plate body.2. The distal radius plating system of claim 1, wherein the lateralextension portion laterally extends from the radial edge of the volarplate body at an intermediate portion of the radial edge between theproximal edge and the distal edge.
 3. The distal radius plating systemof claim 2, wherein the intermediate portion is approximately at amiddle portion of the radial edge between the proximal edge and thedistal edge.
 4. The distal radius plating system of claim 1, wherein thevolar head portion has a size and shape to bring at least a portion ofthe distal edge in contact with the radius bone adjacent to the lunatefacet.
 5. The distal radius plating system of claim 1, wherein the volarhead portion has a size and shape to bring at least a portion of thedistal edge in contact with a volar ulnar portion or a volar ulnarfragment of the radius bone.
 6. The distal radius plating system ofclaim 1, wherein the volar head portion has a size and shape to extendleast a portion of the distal edge adjacent to a watershed line of theradius bone at a volar ulnar corner but not at the watershed line of theradius bone at a radial side of the radius bone.
 7. The distal radiusplating system of claim 1, wherein the volar plate body defines alongitudinal channel on the bone-facing surface, the longitudinalchannel having a size and shape to interface with at least a portion ofthe radius bone.
 8. The distal radius plating system of claim 1, whereinat least a portion of the volar head portion is angled outwardly fromthe volar plate body from the bone-facing surface to the exteriorsurface.
 9. A distal radius plating system, comprising: a volar platebody, the volar plate body having an exterior surface and a bone-facingsurface opposing the exterior surface, a radial edge and an ulnar edgeopposing the radial edge, and a proximal edge and a distal edge opposingthe proximal edge, the volar plate body longitudinally disposed betweenthe proximal edge and the distal edge and having a size and shape forinterfacing with a volar side of a distal portion of a radius bone viathe bone-facing surface, the volar plate body defining a plurality ofapertures from the exterior surface to the bone-facing surface toreceive fixation fasteners therethrough to fix to the radius bone, thevolar plate body having a volar head portion extending from the volarplate body and terminating at the distal edge, the volar head portionincluding a first set of apertures from the exterior surface to thebone-facing surface to receive fixation fasteners therethrough to fix tothe radius bone and having a second set of apertures from the exteriorsurface to the bone-facing surface to receive stabilization wiretherethrough to interface with the radius bone; and a radiallongitudinal portion extending from the radial edge of the volar platebody, the radial longitudinal portion having a lateral extension portioncoupled with the volar plate body and a radial extension portion coupledwith the lateral extension portion, the lateral extension portioncurving from the exterior surface toward the bone-facing surface, theradial extension portion extending in a direction from the proximal edgetoward the distal edge, the radial extension portion having a radialexterior surface and a radial bone-facing surface opposing the radialexterior surface, the radial extension portion having at least a firstaperture from the radial exterior surface to the radial bone-facingsurface to receive fixation fasteners therethrough to fix to the radiusbone and having at least a second aperture to receive stabilization wiretherethrough to interface with the radius bone, wherein the firstaperture of the radial extension portion has a larger cross-sectionalarea than the second aperture of the radial extension portion, andwherein at least a portion of the radial bone-facing surface issubstantially orthogonal to at least a portion of the bone-facingsurface of the volar plate body.
 10. A method of treating a patienthaving a distal radius fracture using a distal radius plating system,comprising: introducing a distal radius plating system to a distalportion of a radius bone of a patient through a volar incision on thepatient, the distal radius plating system including a volar plate body,the volar plate body having an exterior surface and a bone-facingsurface opposing the exterior surface, a radial edge and an ulnar edgeopposing the radial edge, a proximal edge and a distal edge opposing theproximal edge, the volar plate body longitudinally disposed between theproximal edge and the distal edge and having a size and shape forinterfacing with a volar side of the distal portion of the radius bonevia the bone-facing surface, the volar plate body defining a pluralityof apertures from the exterior surface to the bone-facing surface toreceive fixation fasteners therethrough to fix to the radius bone, thevolar plate body having a volar head portion extending from the volarplate body and terminating at the distal edge, the volar head portionincluding a first set of apertures from the exterior surface to thebone-facing surface to receive fixation fasteners therethrough to fix tothe radius bone and having a second set of apertures from the exteriorsurface to the bone-facing surface to receive stabilization wiretherethrough to interface with the radius bone, and a radiallongitudinal portion extending from the radial edge of the volar platebody, the radial longitudinal portion having a lateral extension portioncoupled with the volar plate body and a radial extension portion coupledwith the lateral extension portion, the lateral extension portioncurving from the exterior surface toward the bone-facing surface, theradial extension portion extending in a direction from the proximal edgetoward the distal edge, the radial extension portion having a radialexterior surface and a radial bone-facing surface opposing the radialexterior surface, the radial extension portion having at least a firstaperture from the radial exterior surface to the radial bone-facingsurface to receive fixation fasteners therethrough to fix to the radiusbone and having at least a second aperture to receive stabilization wiretherethrough to interface with the radius bone, wherein the firstaperture of the radial extension portion has a larger cross-sectionalarea than the second aperture of the radial extension portion, whereinat least a portion of the radial bone-facing surface is substantiallyorthogonal to at least a portion of the bone-facing surface of the volarplate body; and securing at least a portion of the distal radius platingsystem to the distal portion of the radius bone.
 11. A method oftreating a patient having a distal radius fracture using a distal radiusplating system, comprising: introducing a distal radius plating systemto a distal portion of a radius bone of a patient through a volarincision on the patient, the distal radius plating system including avolar plate body, the volar plate body having an exterior surface and abone-facing surface opposing the exterior surface, a radial edge and anulnar edge opposing the radial edge, a proximal edge and a distal edgeopposing the proximal edge, the volar plate body longitudinally disposedbetween the proximal edge and the distal edge and having a size andshape for interfacing with a volar side of the distal portion of theradius bone via the bone-facing surface, the volar plate body defining aplurality of apertures from the exterior surface to the bone-facingsurface to receive fixation fasteners therethrough to fix to the radiusbone, the volar plate body having a volar head portion extending fromthe volar plate body and terminating at the distal edge, the volar headportion including a first set of apertures from the exterior surface tothe bone-facing surface to receive fixation fasteners therethrough tofix to the radius bone and having a second set of apertures from theexterior surface to the bone-facing surface to receive stabilizationwire therethrough to interface with the radius bone, and a radiallongitudinal portion extending from the radial edge of the volar platebody, the radial longitudinal portion having a lateral extension portioncoupled with the volar plate body and a radial extension portion coupledwith the lateral extension portion, the lateral extension portioncurving from the exterior surface toward the bone-facing surface, theradial extension portion extending in a direction from the proximal edgetoward the distal edge, the radial extension portion having a radialexterior surface and a radial bone-facing surface opposing the radialexterior surface, the radial extension portion having at least a firstaperture from the radial exterior surface to the radial bone-facingsurface to receive fixation fasteners therethrough to fix to the radiusbone and having at least a second aperture to receive stabilization wiretherethrough to interface with the radius bone, wherein at least aportion of the radial bone-facing surface is substantially orthogonal toat least a portion of the bone-facing surface of the volar plate body;introducing the radial extension portion of the distal radius platingsystem to a radial styloid portion or a radial styloid fragment of theradius bone while simultaneously introducing the bone-facing surface ofthe volar plate body to the volar side of the distal portion of theradius bone; and securing at least a portion of the distal radiusplating system to the distal portion of the radius bone.
 12. The methodof claim 11, wherein the lateral extension portion of the distal radiusplating system laterally extends from the radial edge of the volar platebody at an intermediate portion of the radial edge between the proximaledge and the distal edge.
 13. The method of claim 12, wherein theintermediate portion is approximately at a middle portion of the radialedge between the proximal edge and the distal edge.
 14. The method ofclaim 11, further comprising: introducing the distal edge of the volarhead portion of the distal radius plating system to the radius boneadjacent to the lunate facet.
 15. The method of claim 11, furthercomprising: introducing the distal edge of the volar head portion to theradius bone in contact with a volar ulnar portion or a volar ulnarfragment of the radius bone.
 16. The method of claim 11, furthercomprising: introducing the distal edge of the volar head portion to theradius bone adjacent to a watershed line of the radius bone at a volarulnar corner but not at the watershed line of the radius bone at aradial side of the radius bone.
 17. The method of claim 11, whereinintroducing a distal radius plating system to a distal portion of aradius bone of a patient through a volar incision on the patientincludes: introducing the volar side of the distal portion of the radiusbone to a longitudinal channel on the bone-facing surface of the volarplate body.
 18. The method of claim 11, wherein securing at least aportion of the distal radius plating system to the distal portion of theradius bone includes: introducing a fixation fastener to at least one ofan aperture of the plurality of apertures of the volar plate body, anaperture of the first set of apertures of the volar head portion, or thefirst aperture of the radial extension portion.